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Lazy Eyes or Lazy Brain? Strabmisus (Eye Turn)

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Eye Turn (Strabismus)

Strabismus is the condition in which a person is unable to align both eyes. When both eyes do not point at an object at the same time, it results in the appearance of one eye turning in, out, up, down. This eye turning may be:

  • constant (one eye turns all the time)
  • intermittent (an eye only turns sometimes or when looking either close or far)
  • alternating (person switches between which eye turns)

There are many different causes of strabismus and the treatment is dependent on the specific type and cause. Many doctors have said that strabismus can only be treated before a certain age, however, strabismus can be treated at any age! Some factors favor younger patients, while treatment with adults can be easier because of better compliance and motivation. Treatment may consist of prescription lenses, prisms, and a program of vision therapy.
In certain patients, surgery may be recommended in conjunction with vision therapy. Surgery may cosmetically straighten the eyes, but does not improve visual function. This is because if you think back to the problem in strabismus- the strabismus is not a problem with the eyes or muscles controlling the eyes, it is a problem with the brain. Surgery cannot change the brain. The prognosis for optimal outcome in these cases where surgery is indicated is enhanced through pre and post-surgical vision therapy.

Whether it is constant or intermittent, strabismus always requires treatment. It rarely goes away by itself nor will children outgrow it. Many people with strabismus do not realize their own problems and often seek treatment because they do not like the look of the eye turn. However, they also often experience symptoms without knowing it. When the 2 eyes are not lining up the brain has 2 options: either see double vision or turn one eye off (suppression). Most patients that develop strabismus at a young age turn the one eye off. This may sound like a good thing, but whenever the eye is open it is on and it takes energy to turn the eye off which is making the brain less efficient for learning.

Many patients with strabismus experience:

  • diplopia
  • poor depth perception (difficulty catching and hitting balls in sports, difficulty driving or parking a car,
  • inability to see 3D movies, difficulty with jobs that require precise depth perception such as surgery and dentistry)
  • amblyopia (reduce vision in one eye due to the eye being turned)
  • poor coordination (difficulty riding a bike without training wheels)
  • slower visual processing speed (slower at reading and test taking)

So how can vision therapy help these patients?

Vision therapy is a re-training of the brain how to properly control the muscles that move the eyes, both independently and as a team. With vision therapy there are several tools for a person to learn how their vision is functioning and how they can change their eye alignment. In comparison to surgery, which just cuts and moves the muscles, therapy allows the brain to learn the proper signals to align the eyes. This process of learning how to control the eyes creates new neural pathways for the brain to send the correct signals for the eyes to correctly align. Unlike surgery, therapy does take significant time and effort to re-train the brain, but the results are lifelong and well worth the effort without any side effects like a surgery would have! You can go to see our stories about patients with eye turns who completed therapy both on our website and Facebook page!

Written by Dr. Holly Ternus

Dr. Holly Ternus is originally from Torrington, Wyoming, and graduated from the University of Nebraska-Lincoln with a degree in biological sciences. She graduated with Honors from The New England College of Optometry and completed internships with Honors at South Boston Community Health Center with an emphasis in glaucoma and narrow-angle glaucoma, Togus Veterans Affairs Medical Center with an emphasis in ocular disease, Lifetime Eyecare in Houston fitting specialty contact lenses, and Brooke Army Medical Center in San Antonio.

Dr. Ternus practiced with ophthalmology in the Dallas/Fort Worth area, specializing in ocular disease, dry eye disease, and emergency care. She then transitioned into primary care, fitting specialty contacts for keratoconus, post-RK, corneal ectasia, and irregular corneas.

Dr. Ternus is an active member of the Nebraska Optometric Association, American Optometry Association, and American Academy of Optometry. She received her fellowship with the American Academy of Optometry in 2018 and is a graduate of the Nebraska Optometric Association’s Leadership Institute. She also received her fellowship in the Scleral Lens Education Society and is the first in Nebraska to have completed this honor.

Outside of work, Dr. Ternus enjoys spending time with her husband and 2 children, snowboarding, skiing, water sports, watching Husker football, and everything that involves being outdoors.

More Articles By Dr. Holly Ternus

Vision Therapy

Vision therapy is an effective, non-surgical, doctor-supervised treatment that retrains the brain and eyes to work together more efficiently. Rather than compensate for vision problems, vision therapy aims to treat and correct the visual system itself.

Discover how we can help you or your child overcome vision problems such as strabismus and amblyopia, and build a greater sense of confidence. Take our vision therapy quiz today!

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